John Pellerin

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.1772 Issued in AL

Practice address

833 Saint Vincents Dr Ste 403
Birmingham, AL 35205-1614

Phone

(205) 939-0447

NPI assigned

Mar 22, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alabama Orthopedic Spine & Sports Medicine Associates P C

  • Orthopaedic Surgery Physician
  • Birmingham, AL
  • NPI 1659344984
  Medicare reassignment
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1003492984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SAINT VINCENTS DR STE 403",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051614",
            "telephone_number": "205-939-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SAINT VINCENTS DR STE 403",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051614",
            "telephone_number": "205-939-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLERIN",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA.1772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA",
            "identifier": "PA.1772",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larissa Peguero Alemany
• Sarah Pratt Pegues
• Charles Gayle Pelham, PHD
• James Heath Pelham, M.D.
• Jennifer Pelham, CNM
• Sarah Pemberton, RBT
• Fabio Pencle, MD
• Anquenetta Michelle Pendleton Khan
• Tatiana Renee Pendleton, OTR
• Piotr Penherski

• Medical Physician Assistant in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Medical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.